Halcyon Behavioral Health Insurance Coverage for Mental Health
In the United States, more than one in five adults lives with a mental illness each year.1 Yet, in a survey, over 28% of adults with a mental health condition reported that they were unable to get the treatment they needed. In fact, 42% of these people said the cost alone prevented them from accessing necessary mental health services.2
Finances are one of the big barriers keeping individuals and families from seeking help. Like treatment for physical health conditions, mental health care becomes far more accessible when insurance is involved. Health plans reduce out-of-pocket costs and open doors to consistent, evidence-based support.
Halcyon Behavioral Health is a prestigious insurance provider in the U.S. with various plans catering to patients with different needs. The team at Mission Connection can help you understand your coverage options and how to navigate the verification process.
This page can also help, as it covers everything you need to know about Halcyon Behavioral Health’s mental health coverage, including:
- What Halcyon Behavioral Health is
- What Halcyon Behavioral covers
- Types of Halcyon insurance plans
- The differences between in-network and out-of-network coverage
- How to check your health insurance plan
- Answers to FAQs about Halcyon Behavioral Health coverage
What Is Halcyon Behavioral Health?
Halcyon Behavioral Health is a national network of over 20,000 physical and behavioral medical providers based in California.3 It is a part of a care organization that began in 2011, founded by orthopedic physicians and physical therapists who wanted to improve musculoskeletal care.
The company combined hands-on clinical knowledge with evidence-based guidance from the CDC, the American Academy of Orthopaedic Surgeons, and the American Physical Therapy Association.
As the program evolved, its virtual care model helped tens of thousands of people. Further, in 2022, Halcyon took an important step forward by bringing together Halcyon Behavioral and PhysMetrics through a merger and acquisition.
Halcyon Behavioral Health has over 19 years of trusted service in the healthcare sector. It is also validated by the international ISO certification.
What Does Halcyon Behavioral Cover?
Halcyon Behavioral insurance plans support people through the following mental and emotional health needs and forms of care:
Mental Health and Eating Disorders
Halcyon Behavioral Health covers the following mental health concerns:
- Anxiety disorders
- Major depressive disorder
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Attention-deficit/hyperactivity disorder (ADHD)
- Substance use disorders
- Eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder
Outpatient Care
Outpatient care integrates into your everyday life, so you can keep working, taking care of family, and handling daily responsibilities as you get mental health support. It works best for people who don’t need to be monitored around the clock.
Outpatient coverage includes the following:
- Regular therapy sessions with licensed providers
- Check-ins with a psychiatrist for medication or progress updates
- Intensive outpatient programs (IOPs)
- Partial hospitalization programs (PHPs)
Halcyon outpatient plans also support virtual therapy so people can access care from home when appropriate.
Inpatient Care
A person typically needs inpatient mental health care when their symptoms get too much to handle on their own. For example, they may be at risk of self-harm or harm to others, or their symptoms may not have been improving despite consistent outpatient therapy.
Halcyon Behavioral Health covers short-term psychiatric hospitalization if it is clinically indicated.
The entire day in inpatient healthcare settings is structured hour-to-hour. It includes daily therapy, regular check-ins with psychiatrists, medication adjustments, coping tools, and 24/7 professional support.
Of course, you don’t stay in inpatient care for too long. As soon as you are stable enough, you will be shifted to outpatient/residential care based on your long-term requirements.
Dual Diagnosis and Co-Occurring Disorders Treatment
Dual diagnosis means having both a mental health condition and a substance use issue at the same time. Insurance providers recognize the fact that the two occur together very commonly, and when present, both conditions need to be treated together.
Care programs for dual diagnosis covered by Halcyon Behavioral Health combine medical services and psychiatric support. For instance, they include medication-assisted treatment (MAT) for opioid or alcohol use disorders when clinically appropriate.
Medication-assisted treatment uses FDA-approved medications such as buprenorphine, methadone, or naltrexone for acute detoxification. It is then followed by behavioral therapies.
Types of Halcyon Insurance Plans
Halcyon offers multiple types of insurance plans. These include:
Halcyon HMO
A Health Maintenance Organization (HMO) plan requires you to choose a primary care provider under whom you decide the course of your treatment. This provider is the central point of your treatment as they coordinate your referrals to specialists when needed.4
Halcyon HMO plans cover mental health treatments within a defined network of doctors, therapists, hospitals, and treatment facilities. So, when you go to in-network providers, your out-of-pocket costs remain as low as possible.
However, these plans can be a little limiting because you can’t go to a specialist doctor unless you get a referral from your primary provider. This additional step is intended to make sure your treatment is appropriate and medically necessary.
Yet Halcyon HMO plans are still very good for regular services, like therapy visits, psychiatric appointments, and wellness check-ins at consistent, manageable costs.
Halcyon PPO
Preferred Provider Organization (PPO) coverage is more flexible than HMO plans. A PPO plan allows you to see doctors, therapists, and specialists without needing a referral from a primary care provider. So, you can seek care more directly.5 With a PPO plan, you also get to receive care from both in-network and out-of-network providers. Naturally, staying in-network results in lower out-of-pocket costs. But the freedom of choosing an out-of-network specialist may be comforting for people who want more control over their mental health care. Halcyon PPO plans cover:- Individual therapy sessions
- Group counseling
- All kinds of psychiatric evaluations
- Medication management for mental health and addiction treatment
- Higher levels of mental health care when medically necessary, such as intensive outpatient programs, partial hospitalization programs, and inpatient psychiatric treatment
Halcyon EPO
Exclusive Provider Organization (EPO) plans create a balance between affordability and access to care. People are not required to choose a primary care provider or obtain referrals to see specialists.
However, unlike PPO plans, EPO coverage is limited to a specific network of providers. Services are only covered when care is received in-network, except in emergency situations. So Halcyon EPO plans provide comprehensive mental health treatment coverage as long as patients remain within the approved provider network.
The services include individual therapy, group therapy, family counseling, mental health and psychiatric evaluations, and medication management. When needed, they also cover structured levels of behavioral health care, provided they are delivered by in-network facilities.
Halcyon POS
Point of Service (POS) plans combine features of both HMO and PPO insurance models. They allow you to select a primary care provider who coordinates all your treatments and provides referrals for specialists when needed.
At the same time, POS plans allow people to seek care outside the network, though at a higher out-of-pocket cost.
The POS coverage at Halcyon Behavioral Health includes outpatient and inpatient services when referred.
High-Deductible Plans
Halcyon high-deductible health plans are a good option for people who want lower monthly premiums and don’t mind taking on more upfront costs. With these plans, you’ll pay more out of pocket at the start of the year until you reach your deductible.
After that deductible is met, the plan starts sharing the cost through copays or coinsurance, so your financial burden for recurring treatment payments is reduced.
These plans still cover the same range of services as other Halcyon options, including therapy, psychiatric care, medication management, and higher levels of behavioral health treatment when medically necessary. Preventive mental health services or annual wellness visits may still be covered at no cost.
You can also pair Halcyon high-deductible plans with a health savings account. That way, you could set aside pre-tax money to use for mental health and medical expenses.
Medicare Advantage and Supplement Plans
Halcyon Medicare Advantage and Medicare Supplement plans are best suited for two subgroups:
- Older adults
- People living with qualifying disabilities
The Medicare Advantage plans are also known as “Part C.” 6 A private insurer like Halcyon Behavioral offers Part C, which in itself is a combination of Medicare Part A and Part B in one convenient option. It basically covers all outpatient and inpatient services under a single plan.
Halcyon Medicare Supplements are called “Medicaps.” These work a little differently. Your Medigap will not replace original Medicare. Instead it will be used with it to cover out-of-pocket costs.
Difference Between Halcyon in-Network vs. Out-of-Network Coverage
There’s a difference in the amount you end up paying with in-network versus out-of-network mental health coverage plans.
An in-network mental health provider has an agreement with the Halcyon Behavioral Health network to provide their services at set, discounted rates. Subsequently, you bear lower copays and deductibles, since your insurer is covering more of the cost. Therefore, in-network care also tends to be predictable because you know there won’t be any surprise bills.
Out-of-network care works differently. If a provider doesn’t have a contract with Halcyon, your insurance will only cover a small portion of the cost, or sometimes, none at all.
It’s also good to note that HMO and EPO plans do not cover out‑of‑network services at all, except in true emergencies.
How to Check Your Halcyon Behavioral Health Insurance Plan
You need to know what Halcyon Behavioral Health insurance plan you are on to understand your coverage and prepare for any out-of-pocket costs.
The best way to review your plan is by visiting the Halcyon website and logging into your member portal. There, you will see all your benefits and can review your coverage details. It will also show you a list of providers so you may select your preferred provider and check any requirements or restrictions for mental health services.
Additionally, your insurance card contains information about the type of insurance plan you are on. You can find your policy number and customer service contact details on it.
If you’re ever unsure about your coverage, you can reach out to Mission Connection Healthcare. We offer free insurance verification for Halcyon Behavioral Health plans. Our team will contact your insurance provider on your behalf to confirm your benefits and how your plan applies to the services you may need.
Mission Connection Healthcare Accepts Halcyon Plans
If you are covered by Halcyon insurance, you may already qualify for comprehensive, life-changing mental health and addiction treatment at Mission Connection.
We also offer free verification services to help you clearly understand what your Halcyon plan covers and whether any out-of-pocket costs apply before therapy begins.
Our programs include structured inpatient care, outpatient services, and secure telehealth options. Plus, care at Mission Connection is provided by licensed professionals who are deeply committed to your healing. Our programs meet rigorous quality standards through Joint Commission International certification.
If you would like to start the insurance verification process or have further questions about treatment, reach out to our team or get started online today.
FAQs About Halcyon Behavioral Health
If you’re considering treatment through Halcyon Behavioral Health, you may have some ongoing questions after the information on this page. For this reason, we’ve provided answers to some of the most commonly asked questions about Halcyon we receive.
What’s the Difference Between Mental Health and Behavioral Health Insurance Coverage?
Mental health coverage includes treatment for depression, anxiety, bipolar disorder, and trauma-related disorders.
Behavioral health coverage also includes the impact of these diagnoses on your actions, such as substance use and personality changes. It covers these aspects alongside your mental health treatment.
Does Halcyon Behavioral Cover Rehab?
Yes. Halcyon Behavioral covers medically necessary rehab services, which include both inpatient and outpatient treatment for substance use disorders.
Do You Need Pre-Authorization From Halcyon to Begin Mental Health Treatment?
In most cases, you do. At Mission Connection, our admissions team coordinates with Halcyon to obtain any required pre‑authorizations before your treatment begins.
References
- National Institute of Mental Health. (2024, September). Mental Illness. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/mental-illness
- Mental Health America. (2025, March 7). The State of Mental Health in America. Mental Health America. https://mhanational.org/the-state-of-mental-health-in-america/
- Halcyon Behavioral Health. (2022). About Us. Simpletherapy.com. https://www.simpletherapy.com/en/about/
- Falkson, S. R., & Srinivasan, V. N. (2023). Health Maintenance Organization (HMO). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554454/
- Davy, J. D. (1984). Preferred Provider Organizations. American Journal of Occupational Therapy, 38(5), 327–329. https://doi.org/10.5014/ajot.38.5.327
- Xu, L., W. Pete Welch, Ruhter, J., Nguyen, N. X., Sheingold, S., Nancy De Lew, & Sommers, B. D. (2023, May). Medicare Advantage Overview: A Primer on Enrollment and Spending. Nih.gov; Office of the Assistant Secretary for Planning and Evaluation (ASPE). https://www.ncbi.nlm.nih.gov/books/NBK604796/